jprez562: Escitalopram tough journey

[jprez562]

Hello all-

 

i just want to introduce myself to the group. I have been a long time reader and follower. I just decided to create account. I will be totally honest.\

 

Back in 2014 Started using steroids to enhance my body building. I never used before but all my coworkers used them and so i started a 8 week cycle. After stopping them and going through the whole post cycle therapy, i started to experience what i did not know at the time was anxiety attacks for no apparent reason. Please note i never had panic or anxiety attacks before.

 

On July 4, 2014 i experienced a full panic attack while sitting down watching TV. This panic attack felt like i was going to die! I was short of breath, sweating, dizzy, like i was about to faint. Right after that attack i was not the same. I felt the after effects. i was scared to have another one, i had brain fog, anxiety, Depersonalization, suicidal thought which scared me to my wits. I became depressed because i didn't know what was wrong with me. I stayed that way for two days, until i went to urgent care. I was given a injection and calmed down for the rest of the day. I was sent home with xanax, and instructions to see a Psychiatrist. 

 

Once i seen the doctor she diagnosed me with GAD. Wrote me prescription for Escitalopram 10mg, and xanax 0.25mg as needed. I started taking the Escitalopram 10 mg at night and immediately couldn't sleep, had racing thoughts, and was more anxious. Next day she instructed me to take it in the morning. That seem to do work better than taking it at night. Eventually my symptoms were gone except that i was tired alot and my libido was down. She prescribed me Bupropion SR 150 which i made me feel like my mind was going 100 mph. I stopped Bupropion SR 150 and she switched me to Bupropion Xl 150 and then 300 mg which combated the tiredness. At this dose of Bupropion XL i had motivation, my libidio returned, and my energy level improved. 

 

Fast forward to last year November 2016 when i decided i want to give it a shot and taper off lexapro first. With my doctor agreeing with me, i started to cut the 10 mg pill into 4 pieces. I weaned myself down to the point that i couldn't cut the 5mg pills to get a accurate dose. That's when i researched on SAD on how turn Escitalopram into a liquid form. See my signature for my tapering doses.

 

Recently my employer started restructuring the company, Unsure of my future i started interviewing and testing for other potential employers. During the interviews i was so nervous i took 0.25mg xanax to calm me down. This was last month in August 2017. My latest taper was on August 14, 2017 i was at 0.7mg and reduced to 0.6mg/1.2ml - 2:1 ratio of Escitalopram. During on of the testing for this new job i was on the verge of having a panic attack. Not sure why since i was not nervous nor worried about the testing portion. I had no choice but to push through since we could not leave the room at all! I managed to finish the test but i was not feeling to good, so i took 0.25mg of Xanax which helped. After the testing episode i have been noticing that when i go into a important meeting i start to panic. i get dizzy, sweaty,  and anxious. I feel like i want to run out of there. It got to the point that before one certain interview with a potential employer i have taken 0.125mg of xanax to get through it. And after all that i actually go the job!

 

I decided to return to my latest dose i felt i was stable at which was 0.7mg/1.4ml of Escitalopram in liquid form. I increased my dose on September 10, 2017 I was hoping this will help. I was ok for 3 days until i had to make more liquid Escitalopram with distilled water. I bought some 10ml bottles so just in case i have to travel i have a small enough jar or vial to carry around. So after this mixture the new ratio will be 1:1. I crushed two 5mg pill of Escitalopram and added 10ml of distilled water. After a couple of hours i took my dose at 0.7ml = 0.7 mg 1:1 ratio. I am not sure what happened but maybe the powder that sits at bottom didn't have enough space to properly mix with the water, because right after i took this dose i was on the verge of having a panic attack and i haven't been the same since. I had to do breathing techniques. That worked for like 15 minutes but i was very irritated, i couldn't stay still, i had racing thoughts coming into my head, heart was pounding, i felt dizzy. I had to take 0.25mg to calm down to be able to sleep. i woke up around 1100pm the same night and felt anxious and i took a extra 0.125 mg of xanax again to fall asleep. I had to call in sick to a golf tournament with my new boss, and some clients. 

 

Now ever since then i have been on edge, i feel ok one moment and the next, i am anxious, i get racing thoughts, my left eye is twitching a lot.  i worry that i won't be able to perform at my new job which is very demanding. 

 

Yesterday i did my original mixture of Escitalopram 2:1 ration in a slightly larger jar and i took my dose at 1.4ml/0.7mg of Escitalopram and bupropion xl 300 mg. I did not have the same episode i did the previous night.

 

I this point i don't know what to do. Should i stay at my current dose and try to stabilize, lower my dose, ???

 

your help and input is much appreciated. 

 

Thanks

[bubble]

Hello jprez and welcome to SA.

 

Sorry we still haven't gotten round to greeting you but I guess it's slow at the weekends. I was just about to switch off to get some rest but still decided to drop you a lime so that you know we have seen you. As you can see from my signature I'm also struggling with Lexapro (and Xanax) after many years of drug exposure

 

Lexapro is a real beast and a very strong antidepressant. So although you have been tapering responsibly it has still been too fast an the symptoms you are having are telling you that. I definitely wouldn't cut any further. You might even need to updose a bit more. Updosing would be preferable than getting addicted to Xanax which can happen before you know it. 

 

I would also encourage you to check into our benzo sub-section to get an opinion on your Xanax use and look into how much as needed really is.

 

Here are some links that you may want to check if you haven't already.

 

 

What is Withdrawal Syndrome?

Withdrawal Symptoms - Delayed Onset

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Healing generally happens in a windows and waves pattern of stabilization.  Waves mean your nervous system is struggling to heal.  It moves in the right direction for a bit then falls back a bit.  This is normal. You can view the "better" part of the wave as when your nervous system is finding its balance.  These periods will get longer and more frequent as time goes on.  The link below might help you understand a little better.

 

Windows and Waves Pattern of Stabilization

What is Happening in Your Brain

 

Thank you for creating the signature. This is your thread for asking for any questions you may have. I would also encourage you to look around and visit other people's threads. you will see that a lot of us are going through the same states and that it is a very supportive community. Given that we are so alone in this it means the world.  

 

Once again, welcome.

 

Bubble

[jprez562]

Bubble,

 

Thank you for your reply. I will definitely check out the links you provided. 

 

Today 9-17-17 i feel slightly better but not good, i woke up feeling wired, restless, in order to go back to sleep i have to listen to meditation video for sleep and anxiety. 

 

The last dose of xanax i took was 2 days ago. When i was stable i went months without taking one. I really try to avoid taking xanax unless i really have to. It's good to know i have it there when i need it but from reading posts on SA i can see xanax can become a major issue.

 

So the last up dose of lexapro i did was about 7 days. i went up 0.1 mg/ml of lexapro. 3 days later i was about to have a panic attack immediately after taking my lexapro dose, which i believe was an accidental up dose from changing the ratio. i haven't been right ever since.

 

i know the decision is mine to make, but do you suggest i hold my current dose longer and see if i stabilize?

 

should i up dose ? if so how much?

 

I appreciate the support and advice from this community.

 

Thanks,

 

jprez

 

 

 

 

 

[ChessieCat]

Hi jprez and welcome from me too,

 

4 hours ago, jprez562 said:

So the last up dose of lexapro i did was about 7 days. i went up 0.1 mg/ml of lexapro. 3 days later i was about to have a panic attack immediately after taking my lexapro dose, which i believe was an accidental up dose from changing the ratio. i haven't been right ever since.

 

i know the decision is mine to make, but do you suggest i hold my current dose longer and see if i stabilize?

 

should i up dose ? if so how much?

 

So this possible increase in dosing was only 4 days okay?  It takes 4 days for a dose to get to steady state in the blood and a bit longer for it to register in the brain.

 

It could take a few weeks before things stabilise.  It would be better to stick to the dose you are taking and Keep Notes on Paper

 

Also see:

 

Keep it Simple, Slow and Stable

 

Rate Symptoms Daily to Check Patterns and Progress

 

Windows and Waves Pattern of Stabilization

[jprez562]

Chessie Cat,

 

Thank you so much for your input. My last increase was 7 days ago. It's just mind boggling to me how 0.1mg of lexapro can have this effect on me. The possible over up-dose was 3 days ago. I will hold for another week and monitor my symptoms. i am recording my symptoms and feelings on my phone since i always have it with me. i will also start rating them. If my symptoms don't improve by then, i might up dose again like bubbles suggested. Not sure how much though....

 

Today i was pretty depressed. i had a moment where i thought this will never end and i will feel this way for a long time. My wife is supportive but she does not understand. 

 

one thing i did notice yesterday as i was taking my doses, i took the Bupropion 300 mg and felt my heart pumping and i felt my anxiety trying to rise up, i was able to control it ny breathing. Maybe i should take it in the morning so i can sleep better as i am waking up with anxiety??

 

I did go through your website and i find it encouraging that you did up dose successfully when symptoms got bad. i just hope i stabilize soon, and if i don't i hope a up dose will be the key.

 

Makes me think i should have just stayed on my dose at 10 mg when i was doing good, but now i am where i am. I sure am glad i have the support and advice from SA.

 

Thanks 

 

jprez

[ChessieCat]

My compounding pharmacist told me the other day that one of his customers took about 18 months or so to get off 1 mg escitalopram.

 

We have many member here that find that the lower their dose gets the slower they need to go.  This discussion is very interesting:

 

Why taper paper: dose-occupancy curves

[jprez562]

wow that is a slow taper of 1 mg in 18 months. now i see i was going faster than i should.

 

SHould i skip my Bupropion 300 mg dose and take it in the morning due to the symptoms i felt yesterday ?? 

my heart pumping and i felt my anxiety trying to rise up

 

Thanks 

 

jprez

 

 

[Gridley]

Very helpful, as always.  I save these posts for guidance the time in the future when I hit 1 mg.

[jprez562]

 

After 400 pm today i started feeling good. Had some eye twitching that has been going on for some weeks now, had a headache took 600mg ibuprofen, my daughter massaged my temples and it eased off a bit.

 

For some reason when i took my self made liquid lexapro dose today i feel my heart starts pumping a little faster and i feel a raise in my anxiety. 

 

This happened to me yesterday with Bupropion 300 mg. 

 

why is that happening ? anyone else experiance this ???

 

maybe i am just paranoid from the other night when i think i accidently up dosed and i had a anxiety attack..

 

 

[ChessieCat]

What time of the day is this happening?

[jprez562]

In the evening. 830 pm right after I take my dose. Never happened before 

[ChessieCat]

You said it happened when you took your bupropion.  You are taking them both in the evening.    Are you taking them at different times?  If you are taking them separately, which one do you take first?

 

Has anything else not related to escitalopram or bupropion changed?

 

Did you take ibuprofen the previous time?

 

Have you been eating or drinking anything different the nights which this has happened?

 

Have you been watching a TV program which has raised your stress levels, eg excitement, distressing, high tension, angry - this raises cortisol levels.

 

From the Drug Interactions Checker:  buPROPion can increase the blood levels of escitalopram, which may increase other side effects.

 

It may also be from the possible dosage error several days ago.

[jprez562]

Chessie cat,

 

Are you taking them at different times? No i was not. i was taking them at exactly the same time, however i just skipped a dose of bupropion to take this morning. 

 

 

 If you are taking them separately, which one do you take first? Bupropion first followed by Lexapro 

 

Has anything else not related to escitalopram or bupropion changed? I did recently add magnesium 400 mg a day and started drinking passion tea flower.

 

Did you take ibuprofen the previous time? no. just yesterday when i had a headache

 

Have you been eating or drinking anything different the nights which this has happened? no

[jprez562]

Update:

 

I slept much better last night. I listen to meditation video on youtube and fall asleep. 

 

I woke up with almost no anxiety.

 

i just feel a little groggy, and zoned out but not as much as yesterday. I just catch myself thinking about how maybe i should of just stayed on my dose i was doing good at. I also think about the long road ahead and it gets me depressed and worried. If i stabilize like i think i am doing slowly, is it possible to hold this low dose of  0.7mg for a long time?

 

Not sure if i want to continue the taper..lol Just need some guidance and support.

 

My wife tells me not to be all on the internet reading because i worry myself if i read stories of others how they struggle and cant stabilize.

 

jprez 

[TheWayBack]

Hi jprez562

 

I know exactly how you feel. Had the same happening to me. Tapered without trouble down to 1.5mg, upped between 0.1 and 0.5mg for a few days and was very restless. Upped more to 2mg and in a couple of hours had continuous panic attacks for days. Tried holding it hoping to stabilize but in three weeks still not OK. Upped even more hoping to stabilize to 5mg and was in for a very bad time for 30 days. Today is the first more normal day.

 

So, in MY OWN opinion you should immediately go as low as you were before and HOLD there. Do not updose immediately. I had lots and lots of trouble doing that. Give it time and see what it does in a couple of days/week or 2.

 

Updosing can make you incredible unstable at these low dosages. The escitalopram does NOT help against fear in ANY way at these dosages. You have to go to 5mg/10mg to have an anti-anxiety/panic effect. Updosing at these low dosages was fear and anxiety provoking. So in my own humble opinion and recent experience, try to hold as low as you were for a longer time, maybe 0.6 or 0.7mg. Keep it there for a while. If it doesn't help you can reassess the situation.

 

Just my two cents. Hope you get it fixed very soon! Oh and read 'Hope and help for your nerves' ASAP. Get it as an ebook on your phone. It helps tremendously with the panic attacks! Oh and read it again

 

But again, listen to the mods, I just had to respond because I had the same thing happened to me this summer.

[jprez562]

The way back,

 

Thank you for your input. I am glad you are feeling some improvements.

 

I agree that i will stay at my current dose and take it from there. might stay there for ever lol..

 

I remember when i first started Lexapro i was good in 3 weeks. i started taking 5 mg for one week and upped my dose to 10 mg the second week and i was feeling the side effects like i was feeling recently, but i don't remember if they were worse or the same. All i know is we don't like them side effects and symptoms. 

 

I have a nice supply of xanax that i have been able not to take. The last dose i took was 4 days ago. I only take it when in emergency or if can't take the depression or racing thoughts etc... reading the post on SA has me cautious on taking the xanax.

 

I am starting to look into CBT therapy. I will look for a therapist to assist me. maybe a local support group. 

 

jprez

 

 

[bubble]

Holds are very, very beneficial. It is the time when our brain is actually rewiring itself.

 

Our goal doesn't have to be to come off of a drug completely but to simply reduce our drug load. At low doses their adverse effects get so much lower too. Some people including myself do month long holds. Last year I had to hold for 9 months.

 

As a Xanax victim I can't urge you enough to stay away from it. In general I like your idea of a (very) long hold and looking into therapy. I really think this is the way to go. Good luck!

[jprez562]

So I have been tapering off lexapro and currently at 0.7mg. I am also on Wellbutrin XL 300mg. Should I have tapered off welbutrin first?

[ChessieCat]

Here's a link:

 

Taking multiple psych drugs? Which drug to taper first?
If you're not having an adverse reaction from the other medications, taper the most activating drug first. This is usually an antidepressant or stimulant (ADHD drug).

[TheWayBack]

Wellbutrin is pretty activating. Taper it slower than your escitalopram.

[jprez562]

Chessie cat / the way Back - are you suggesting i hold my current dose of lexapro, stabilize, and then taper wellbutrin XL?

[jprez562]

UPDATE:

 

Yesterday I woke up feeling a little anxious, and somewhat depressed.

 

In The afternoon i felt good. Like i was stabilizing, i was feeling pretty good.

 

Today i woke up feeling out of it, while driving to work, i was feeling depressed again. Better then last week though.

 

I hope this is a  sign that stabilization is drawing near.

[bubble]

Stabilization takes time (more as a matter of weeks rather than days) and it is not linear.

 

Healing generally happens in a windows and waves pattern of stabilization.  Waves mean your nervous system is struggling to heal.  It moves in the right direction for a bit then falls back a bit.  This is normal. You can view the "better" part of the wave as when your nervous system is finding its balance.  These periods will get longer and more frequent as time goes on.  The link below might help you understand a little better.

 

Windows and Waves Pattern of Stabilization

What is Happening in Your Brain

[jprez562]

How would know the difference, if i am having WD symptoms for being on a low dose or if it's the side effects of a up dose ?

[ChessieCat]

It is most likely the result of changing your doses over the last few months.  Or if Wellbutrin is more activitating then it may be that causing some of the issues.

 

It is best to keep notes in the format suggested below.  This might help you to see a pattern.  It's also important to try and stay as calm as possible and learn and use non drug techniques to cope with the discomfort.

 

Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Acceptance

 

Non-drug techniques

[jprez562]

Thank chessiecat

 

how about me switching my welbutrin XL 300mh dose to morning versus nights like I recently did?

 

i skipped the night dose and took in morning yesterday with no problem yesterday felt fine but today it's a different story. 

 

 Thoughts ?

[ChessieCat]

If you wish to change the time you take a drug it is best to move it 1 hour earlier each day (if you want to move a night dose to the morning) so that there is less shock to your nervous system.

 

Edited September 20, 2017 by ChessieCat

[jprez562]

Damn it- i already changed it from 830 pm to 830 am.

 

Update: 

 

Yesterday was a tough day.

 

450 am Morning was feeling zoned out, depressed,

614 am feeling ok. a little sleepy 

 

241 pm Feeling depressed, racing thoughts, sometimes suicidal but i don't want to act no way, and that scares me not knowing why those thoughts come into my head.

 

330 pm depressed and anxious. rated at 8

 

451 anxiety and depression subsided slightly, but thoughts are there 

 

800 pm calmed down in but, took lexapro dose and supplement. mindfulness drinked passion flower and chamomile tea, felt sleepy

 

900pm sleepy and tired.

 

 

 

Last night i slept ok. i woke up better then yesterday. I have lost my appetite, and losing weight. 

 

will provide a update later. praying for better days 

[TheWayBack]

I don't know how intense your symptoms are, but it seems they are manageable? If they are, hold and you will be ok. If I get the zoned out feeling in the morning I know that the escitalopram does more good than bad. If I am anxious and not zoned out, I'm further from stabilizing. This is maybe very personal, but I think you will be OK.

 

Try the floating technique from Claire Weekes to cope. Don't be impressed by feelings or thoughts, fear is playing tricks on you. Notice them, but don't give them much attention. Go on with the current occupation of the moment.

 

Can I suggest you'd better stop drinking the passion flower tea? It's a mild MAO-inhibitor, and I would recommend against it with SSRI's. Chamomille, lavender and lemonbalm are much better and have mild GABA activity. Not as harsh as benzo's and very helpful. Mods maybe have better insights in this.

 

 

 

 

[jprez562]

Update:

 

Hello everyone-  I just wanted to update my thread.

 

the last 2 days and a half have been good. Minimal to no anxiety or depression feeling. Slept good too. Just the occasional eye twitching.

 

Today in the late afternoon intrusive thoughts come out of nowhere, then followed by mild depression. I am guessing it's part of the waves and windows of stabilizing. I'm trying to fight these thoughts off but it's hard. I'm trying mindfulness, I have recommitted to returning to church for spiritual healing and help me move forward. My family has always been close to God and I think it's time for me as well. I know I will have a rough road ahead and I need the guidance of the most high.

 

I have ordered Lemon balm as the way back has suggested. The teas defintly helps. On Wednesday I went for a hike and absorbed the nature, and sounds of birds. I was so at peace it was great. I will be returning tomorrow with my wife and daughter.

 

As I type this I am feeling better. I feel posting on SA makes me feel better. Must be the great people on here.

 

regards 

 

jprez

[jprez562]

Today was rough. Intrusive thoughts with some mild depression in the early evening. 

 

The thoughts are the ones that scares me.

 

Trying to listen to Claire Weeks for some coping skills. Went for a hike earlier and i had my moments when i felt good and moments i felt depressed.

 

Now its 837 pm and i am feeling ok. 

 

hoping for better days 
 

 

 

 

 

[jprez562]

The last three days i have felt pretty good. I had my moments but i have improved a lot based on how i felt 2 weeks ago. 

 

The only thing i currently struggle with is intrusive thoughts, not sure if this is a sign of suicidal ideation but i get images of me grabbing any sharp objects and cutting myself on the wrist..I have no intention of doing anything to myself. I love my life! It almost seems like i try to test myself when i walk by for example a kitchen where i seen a knife to earlier to see how i will react. I noticed those thoughts scare me and get me worried, not sure why i get them.

 

I have made a appointment with a LMFT to see if some form of therapy helps. 

 

At this point i will hold at my current dose, see if i keep improving.

 

Here are some of my plans i plan to do.

 

I will visit my Psychiatrist and see what she recommends, she will most likely ask me " what do you want to do"?  

 

I plan on visiting with a DNP in Psychiatry who had 5 stars rating more than 40 reviews for a second opinion and ask him if he has experience weaning patients off medication. I will ask him if is familiar with discontinuation syndrome. My hope is that he helped enough people resulting in verified high ratings which is unheard of for the majority of Psychiatrist

 

I will see a therapist and hopefully learn CBT.

 

A lot of prayer.

 

 

[jprez562]

Still Struggling with intrusive thoughts. any advise ? 

 

i went to try to see a LMFT and when i told her i was having these intrusive thoughts she said " maybe i am not the right therapist for you, i don't want you to hurt yourself". I was like " i am not going to hurt myself, i just get the thoughts. i want to live!".

 

 

[jkun41]

You can take a gander at my intro thread. It will probably make you feel more normal. 

 

I've had mild OCD my whole life, though I was just formally diagnosed as such this past week. Mine is Pure-O. Obsessional thought and mental compulsions. 

 

The thing to remember about OCD is that the thoughts cause distress because because they involve things we care about. This is especially true with harm, whether for self or others. Even if you don't have OCD we experience intrusive thoughts the same way. 

 

You value your life, so it makes sense your thoughts about this topic are so distressing. 

 

Unfortunately my experience with an ssri has caused my OCD to snowball. First with health anxiety, then existential, and then into a mix of both. I did have a small stretch involving harm though. 

 

Im very much a work in progress, so I probably can't offer you the best advice. 

 

What I can offer is:

 

Your withdrawal/tapering is absolutely making it worse, so there's a reason for it. 

 

Chances are if a thought bothers you, it's unlikely you'll ever take action. The difference between us and normal people is that we get caught on the thought, where as "normal" people simply let it pass by. My therapist offered a good tidbit in this regard: people who let these thoughts pass are closer on the spectrum to the negative extreme than we are. 

[jprez562]

JKun,

 

i have never ever had these symptoms before using lexapro. Can it be I developed it or just part of WD?

[jkun41]

I'm not sure, but IMO it can. There is a topic on here about intrusive thought and OCD and I believe a few of the members had stated they developed these symptoms only during withdrawal. 

 

In a way I am very much the same. My intrusive thinking was extremely mild compared to what I have now, and though I can see where I had OCD in the past it was never prominent enough to seek a diagnosis. The only thing even somewhat comparable was my fear of vomiting as a child. 

 

When I first started struggling with them I did some research and came across a Web page that talked about intrusive thoughts. It stated that in a survey they had done 90% of the responses were the same between people with no anxiety/OCD and people with anxiety/OCD. The difference was that those with anxiety and OCD allowed it to bother them much more. This was especially true in regards to harm. 

 

So whether you have OCD, GAD, Panic, Anxiety, or withdrawal, it's not necessarily your thoughts that are different. It's just that when you had them before you never paid attention to them. You don't remember them cause they didn't bother you. 

 

Thats not to say you don't have new distressing thoughts that you never had before, but these new thoughts are most likely a result of you becoming distressed by thoughts that you did have in the past, the just didn't bother you then. It's a rabbit hole.